高温与湿度对中国死亡率的联合及交互作用。

The joint and interaction effect of high temperature and humidity on mortality in China.

作者信息

Fang Wen, Li Zhixing, Gao Jinghua, Meng Ruilin, He Guanhao, Hou Zhulin, Zhu Sui, Zhou Maigeng, Zhou Chunliang, Xiao Yize, Yu Min, Huang Biao, Xu Xiaojun, Lin Lifeng, Xiao Jianpeng, Jin Donghui, Qin Mingfang, Yin Peng, Xu Yiqing, Hu Jianxiong, Liu Tao, Huang Cunrui, Ma Wenjun

机构信息

Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China.

School of Public Health, Southern Medical University, Guangzhou 510515, China.

出版信息

Environ Int. 2023 Jan;171:107669. doi: 10.1016/j.envint.2022.107669. Epub 2022 Nov 29.

DOI:10.1016/j.envint.2022.107669

PMID:36508749

Abstract

BACKGROUND

Although many studies have reported the mortality effect of temperature, there were few studies on the mortality risk of humidity, let alone the joint effect of temperature and humidity. This study aimed to investigate the joint and interaction effect of high temperature and relative humidity on mortality in China, which will deepen understanding the health risk of mixture climate exposure.

METHODS

The mortality and meteorological data were collected from 353 locations in China (2013-2017 in Jilin, Hunan, Guangdong and Yunnan provinces, 2009-2017 in Zhejiang province, and 2006-2011 in other Provinces). We defined location-specific daily mean temperature ≥ 75th percentile of distribution as high temperature, while minimum mortality relative humidity as the threshold of high relative humidity. A time-series model with a distributed lag non-linear model was first employed to estimate the location-specific associations between humid-hot events and mortality, then we conducted meta-analysis to pool the mortality effect of humid-hot events. Finally, an additive interaction model was used to examine the interactive effect between high temperature and relative humidity.

RESULTS

The excess rate (ER) of non-accidental mortality attributed to dry-hot events was 10.18% (95% confidence interval (CI): 8.93%, 11.45%), which was higher than that of wet-hot events (ER = 3.21%, 95% CI: 0.59%, 5.89%). The attributable fraction (AF) of mortality attributed to dry-hot events was 10.00% (95% CI: 9.50%, 10.72%) with higher burden for females, older people, central China, cardiovascular diseases and urban city. While for wet-hot events, AF was much lower (3.31%, 95% CI: 2.60%, 4.30%). We also found that high temperature and low relative humidity had synergistic additive interaction on mortality risk.

CONCLUSION

Dry-hot events may have a higher risk of mortality than wet-hot events, and the joint effect of high temperature and low relative humidity may be greater than the sum of their individual effects.

摘要

背景

尽管许多研究报告了温度对死亡率的影响，但关于湿度导致死亡风险的研究较少，更不用说温度和湿度的联合影响了。本研究旨在调查高温和相对湿度对中国死亡率的联合及交互作用，这将加深对混合气候暴露健康风险的理解。

方法

收集了中国353个地点的死亡率和气象数据（吉林省、湖南省、广东省和云南省为2013 - 2017年，浙江省为2009 - 2017年，其他省份为2006 - 2011年）。我们将特定地点的日平均温度≥分布的第75百分位数定义为高温，而将最低死亡率时的相对湿度作为高相对湿度的阈值。首先采用具有分布滞后非线性模型的时间序列模型来估计湿热事件与死亡率之间的特定地点关联，然后进行荟萃分析以汇总湿热事件的死亡率效应。最后，使用相加交互作用模型来检验高温和相对湿度之间的交互作用。

结果

归因于干热事件的非意外死亡率超额率（ER）为10.18%（95%置信区间（CI）：8.93%，11.45%），高于湿热事件（ER = 3.21%，95% CI：0.59%，5.89%）。归因于干热事件的死亡率归因分数（AF）为10.00%（95% CI：9.50%，10.72%），女性、老年人、中国中部地区、心血管疾病患者和城市地区的负担更高。而对于湿热事件，AF则低得多（3.31%，95% CI：2.60%，4.30%）。我们还发现高温和低相对湿度对死亡风险具有协同相加交互作用。